tbuckley/cabot-search huggingface dataset:
POS0727 IMPACT OF AIR POLLUTANTS ON DISEASE ACTIVITY AMONG PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) IN MALAYSIA
Authors: J. H. Jaafar, S. S. Shaharir, S. Rajalingham, R. Mohd, M. T. Latif
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic Lupus erythematous (SLE) is an autoimmune disease with a wide spectrum of clinical manifestations and characterized by remission and flares. Recent epidemiological studies postulated that air pollution confers an increased risk of flare in various autoimmune diseases. Haze is a common phenomenon afflicting Southeast Asia (SEA), including Malaysia, and has occurred almost every year within the last few decades. Objectives This study was aimed to determine the correlation and association between SLE disease activity with exposure to inhaled Particulate Matter (PM 10 ) and Nitrogen Dioxide (NO 2) . Methods SLE patients who attended rheumatology and nephrology clinic in University Kebangsaan Malaysia Medical Centre (UKMMC) from June 2019 until March 2020 were recruited. Their medical records were reviewed for retrospective assessments of the disease activity using the Modified-SLE Disease Activity Index (M-SLEDAI) and The British Isles Lupus Assessment Group (BILAG 2004) index from January 2015 until September 2019. Clinic visits with presence of infection or recent change of immunosuppressive treatment of ≤ 3 months were excluded. The average of daily concentrations of inhaled PM 10 (µg/m 3 ), and NO 2 (ppb) were evaluated within 30 days preceding the clinic visits, and the data was obtained from Department of Environment (DOE) Malaysia. Comparison of the means was performed by Student’s t-test; and the correlations between PM 10 , and NO 2 were determined by Pearson’s correlation coefficient. The associations between the effect of daily pollutant concentrations on M-SLEDAI and BILAG 2004 scores were analyzed using the generalized estimating equation (GEE) model, while considering fixed effects for repeated measures. Results A total of 46 patients were recruited with 603 clinic visits were recorded. A significantly higher NO 2 level was found in active disease patients with M-SLEDAI score of ≥ 4 (33.09 ± 9.15 vs 31.09 ± 9.79, p=0.32), and presence of BILAG B and/or A (score ≥ 8), 35.03± 2.97 vs 31.1 ± 9.8, p= 0.003). There were positive correlations between M-SLEDAI scores (r s 0.128, p=0.002) and BILAG scores with NO 2 , (r s 0.142, p&lt;0.001). In the GEE analysis, significant correlations were found between M-SLEDAI score [OR 1.27 (95% C.I: 1.06-1.53), p=0.01] and BILAG score with NO 2 [OR 1.47 (95% C.I: 1.15-2.1.88), p=0.002]. Conclusion Our study suggests that air pollutant NO 2 exposure 30 days prior to clinic visit is associated with high disease activity among patients with SLE in Malaysia. Further prospective study is warranted to confirm this finding. References [1]Fernandes EC, et al. Exposure to Air Pollutants and Disease Activity in Juvenile-Onset Systemic Lupus Erythematosus Patients. Arthritis Care Res (Hoboken). 2015 Nov;67(11):1609-14. Acknowledgements Department of Environment (DOE), Ministry of Environment And Water, Malaysia Disclosure of Interests None declared
AB0316 SARCOPENIA IN PATIENTS WITH RHEUMATOID ARTHRITIS: PREVALENCE AND ASSOCIATED FACTORS
Authors: N. Toroptsova, O. Dobrovolskaya, A. Sorokina, A. Feklistov, N. Demin, O. Nikitinskaya
Journal: Annals of the Rheumatic Diseases (2022)

Objectives To evaluate the prevalence of sarcopenia (SP) and associated factors in patients with rheumatoid arthritis (RA). Methods 159 women (mean age 58.7±8.8) with confirmed RA according to ACR/EULAR criteria (2010) were enrolled. Hand grip strength was measured using mechanical dynamometry. Dual-energy X-ray absorptiometry (DXA) was performed to assess the body composition and bone mineral density (BMD) of the lumbar spine, femoral neck and total hip. SP was defined as muscle strength &lt; 16 kg and appendicular lean mass index (ALMI) &lt;5.5 kg/m 2 or appendicular lean mass (ALM) &lt;15 kg. RA activity was assessed by C-reactive protein (CRP) and disease activity score using 28 joint counts and erythrocyte sedimentation rate (DAS28-ESR). The relation between low ALM with disease parameters was analyzed using Spearman’s r. Factors associated with SP were evaluated using regression analysis. Results SP was diagnosed in 33 (20.8%) women with RA. Patients with SP did not differ in age from those without it (59,0±8,9 and 58,7±8,8 years, respectively, p&gt;0,05). 75.8% patients with SP and only 27.8% women without SP had normal BMI (p&lt;0.001). Osteoporosis was diagnosed significantly more often in patients with SP than in women without SP (54.5% and 23.0%, respectively, p&lt;0.001). In women with RA, ALM and ALMI correlated with body mass index (BMI), bone mineral component, BMD and total fat mass. ALM and ALMI did not correlate with age, disease duration, the use of glucocorticoids, DAS28, CRP, total protein, and creatinine levels. In univariate regression analysis, SP was associated with BMI, bone mineral component, BMD of lumbar spine and proximal femur, total fat mass. In multivariate regression analysis, SP was positively associated with the presence of osteoporosis [OR 2.98, 95%CI (1.22-7.30), p = 0.017] and BMI &lt; 25 kg/m 2 [OR 6.75, 95%CI (2.45-18.56), p &lt;0.001]. No other significant associations were found. Conclusion Among patients with RA, 1/5 of them had SP, which was positively associated with BMI and the presence of osteoporosis, but not with the age, activity and duration of the disease. Disclosure of Interests None declared
AB0923 Assessment of four screening tools and retrieval of key questions to detect undiagnosed psoriatic arthritis in Chinese patients with psoriasis: a multicenter study
Authors: R. Cui, M. Chen, S. M. Dai
Journal: Annals of the Rheumatic Diseases (2022)

Background The available data showed great discrepancies in the performance of screening tools in detecting psoriatic arthritis (PsA) in patients with psoriasis, and those including the diagnosed PsA in the validation might exaggerate/overestimate the performance. The key questions in each tool were unclear and their contributions were not systematically assessed. Here the performance of four different screening tools were validated and compared in detecting undiagnosed PsA, and the key questions with different weights of them were retrieved and evaluated. Objectives To compare and validate the performance of the four screening tools in detecting undiagnosed psoriatic arthritis (PsA) in Chinese patients with psoriasis, and to determine the key questions and their weights. Methods Consecutive patients with psoriasis but no prior diagnosis of PsA from dermatology clinics and patients with newly diagnosed PsA from rheumatology clinics who were blind to the diagnosis were recruited to complete questionnaires, including early psoriatic arthritis screening questionnaire (EARP), psoriatic arthritis screening and evaluation questionnaire (PASE), psoriasis and arthritis screening questionnaire (PASQ), and psoriasis epidemiology screening tool (PEST). The receiver operator characteristic (ROC) curve with area under curve (AUC) was used to determine sensitivity, specificity and accuracy. The LASSO and logistic regression were utilized to retrieve key questions, and a nomogram was utilized to visualize their weights. Results Of 482 psoriasis patients from dermatology clinics, 77 patients were newly diagnosed with PsA. Another 68 patients with newly diagnosed PsA from rheumatology clinics were incorporated in the analysis. ROC analysis indicated that the optimal cut-off values for EARP, PASE, PASQ and PEST were 3, 40, 7 and 3, with corresponding sensitivities of 91.4%, 88.6%, 86.2% and 88.5%, and specificities of 88.6%, 75.2%, 80.2%, and 83.6%, respectively. The AUC of EARP (0.925) was higher than those of PASE (0.885), PASQ (0.905) and PEST (0.827). A total of twelve key questions were retrieved from these four tools, and their relative weights were scored as 5~100 individually with a nomogram. Conclusion To screen undiagnosed PsA, EARP have slightly better balanced sensitivities and specificities. The retrieved twelve key questions may be helpful in proposing a new questionnaire with different scores of each question to screen PsA more efficiently. Acknowledgements This project was supported by grants from National Natural Science Foundation of China (No. 81771746 and 82071809) and Shanghai Municipal Health Commission (No. 20204Y0255). Disclosure of Interests None declared
AB0139 DEEP IMMUNE PHENOTYPING OF T LYMPHOCYTE SUBSETS IN SYSTEMIC SCLEROSIS PATHOPHYSIOLOGY AND FOLLOWING RESPONSE TO TARGETED CYTOTOXIC TREATMENT
Authors: T. I. Papadimitriou, A. van Caam, J. Lemmers, X. He, E. Vitters, M. Koenders, R. Smeets, M. Vonk, P. van der Kraan, H. Koenen, R. M. Thurlings
Journal: Annals of the Rheumatic Diseases (2022)

Background Abnormalities in T lymphocyte populations are associated with the pathogenesis of many autoimmune diseases, such as systemic sclerosis (SSc). Various studies report on the aberrations of different T cell cytotoxic (CTL) and helper (Th) subsets that appear to be linked with inflammatory and/or fibrotic manifestations of patients with SSc. Since T cells seem to play a pivotal role in the pathophysiology of SSc, targeting the pathogenic T cell subsets might be a promising therapeutic option. Objectives Here we set out to comprehensively compare T lymphocyte phenotypes between SSc patients and healthy donors. We further test the in-vitro efficacy of a combination of anti-CD3/CD7 immunotoxins (CD3/CD7-IT), that have been developed to eliminate activated CD4+ and CD8+ T cells, to study specific sensitivity of T-cell subpopulations to CD3/CD7-IT. Methods 30 SSc patients and 15 age and sex matched healthy donors were included. Of these patients, lymphocyte populations were quantified by 17-parameter flow cytometry of peripheral blood mononuclear cells (PBMCs) to identify CD4+ T helper cells (Th1, Th2, Th17, T peripheral helper), CD8+ naïve, memory, effector CTLs and senescent/exhausted subsets. We next developed a cell killing assay to evaluate the effect of T cell depletion. To address this, patients’ (N=6) PBMCs were first activated for 24 hours in the presence of phytohemagglutinin, followed by CD3/CD7-IT addition for 48 hours. Subset-specific T cell depletion was assessed by using a combination of CellTiter-Glow luminescent cell viability assay and multi-parameter flow cytometric (FCM) quantification of CD3/CD7-IT-induced cell death. Results Frequencies of effector CD8+ CTLs,Th2 and T peripheral helper cells were elevated in SSc patients compared to healthy controls. Furthermore, SSc patients exhibited lower percentages of the anti-fibrotic Th1 subset. A striking expansion of the senescent CD4+CD28- and CD8+CD28- populations was noted in patients, while these subsets were barely detectable in healthy controls. In-vitro adittion of anti-T cell immunotoxins effectively depleted 50 % of patients’ CD8+ T cells (including the CD8 effector subset) and 62% of CD4+ T cells (including Th2 and T peripheral helper cells). No difference in cytolytic sensitivity between different T cell subsets was observed. Conclusion Our findings demonstrate that deep FCM immunephenotyping reveals pathophysiological differences in peripheral T cell subsets of SSc patients. Strikingly, the developed cytolytic assays show that CD3/CD7-IT is able to target the potential disease-associated T cell subsets in an in-vitro setting. References Not applicable Disclosure of Interests None declared
AB0476 PREDICTIVE FACTORS FOR THE DEVELOPMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS IN PATIENTS WITH IMMUNE THROMBOCYTOPENIA
Authors: S. M. Ahn, J. S. Oh, Y. G. Kim, C. K. Lee, B. Yoo, S. Hong
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with immune thrombocytopenia (ITP) have a risk of developing systemic lupus erythematosus (SLE). We sought to examine the clinical characteristics of patients with primary ITP who later developed SLE, and identified the risk factors for the development of SLE. Objectives We retrospectively examined patients who were diagnosed with primary ITP at a tertiary hospital between August 2001 and November 2019. We compared the clinical characteristics according to the development of SLE. Logistic regression analysis was performed to identify the factors associated with the development of SLE. Methods Of 130 patients with primary ITP, 10 (7.7%) were later diagnosed with SLE during follow-up (median, 30 months [IQR, 15.5–105]). The presence of skin bleeding, organ bleeding, lymphopenia, anemia, and positive antinuclear antibody (ANA) titer (&gt; 1:160) were more common among patients who later developed SLE than did those who did not develop SLE. Multivariate analysis showed that young age (&lt; 40 years; odds ratio [OR], 8.359 [95% confidence interval (CI), 1.230–56.793]; p = 0.033), organ bleeding (OR, 18.349 [95% CI, 2.771–121.517]; p = 0.003), and ANA positivity (&gt;1:160; OR, 7.692 [95% CI, 1.482–39.910]; p = 0.015) were significantly associated with the development of SLE. Results Young age (&lt; 40 years), organ bleeding, and ANA positivity (&gt; 1:160) were risk factors for the development of SLE in patients with primary ITP. Conclusion These results suggest that continued follow-up for the detection of SLE development is needed for patients with ITP, particularly those with young age, ANA positivity, or organ bleeding. References [1]Zhu, Fang-Xiao, et al. “Risk of systemic lupus erythematosus in patients with idiopathic thrombocytopenic purpura: a population-based cohort study.” Annals of the rheumatic diseases 79.6 (2020): 793-799. Table 1. Factors associated with the development of SLE in patients with primary ITP Univariate Multivariate OR 95% CI P value OR 95% CI P value Young age a 5.444 1.332–22.250 0.018 8.359 1.230–56.793 0.033 Female 4.333 0.530–35.422 0.17 BMI 0.873 0.717–1.070 0.20 Skin bleeding 8.419 1.034–68.533 0.046 Mucosa bleeding 1.250 0.247–6.330 0.79 Organ bleeding 14.864 3.633–60.815 &lt; 0.001 18.349 2.771–121.517 0.003 Platelet counts 0.911 0.828–1.002 0.06 ANA positivity b 16.500 3.984–68.341 &lt; 0.001 7.692 1.482–39.910 0.015 Neutropenia c 2.111 0.229–19.499 0.51 Lymphopenia d 4.846 1.189–19.759 0.028 Anemia e 10.118 2.044–50.091 0.005 SLE: systemic lupus erythematosus, ITP: immune thrombocytopenia, BMI: body mass index, ANA: antinuclear antibody, OR: odds ratio, CI: confidence interval. a Young age = age &lt; 40 years b ANA positivity ≥ 1:160 c Neutropenia = Absolute neutrophil count &lt; 1500 μL d Lymphopenia = Absolute lymphocyte count &lt; 1500 μL e Anemia = Hemoglobin &lt; 12 g/dL Disclosure of Interests None declared
POS0751 TEMPORAL TREND IN HOSPITALISATION FOR OPPORTUNISTIC INFECTIONS IN PATIENTS WITH CONNECTIVE TISSUE DISEASES.
Authors: J. Nossent, H. Keen, D. Preen, C. Inderjeeth
Journal: Annals of the Rheumatic Diseases (2022)

Background Patients with autoimmune connective tissue disease (CTD) and systemic vasculitis (SV) often require aggressive immune-modulating therapy to prevent organ damage. This however increases the risk for common and uncommon infections. Objectives To compare the temporal rates and associated mortality of hospitalisation with opportunistic infections (OI) for CTD and SV patients in Western Australia between 1985 and 2015. Methods All patients hospitalized in Western Australia in the period 1985-2015 with ≥ 2 ICD based diagnostic codes for SLE (n=1432), other CTD (o-CTD; incl DM/PM, systemic sclerosis, Sjogren’s syndrome; n=2161) and Systemic vasculitis (SV; n=1599) and a microbiologically confirmed OI (Mycobacterial, Fungal and viral infections) were included. Descriptive data are given as median (IQR) and frequency (%). Incidence rates per 1000 person years (IR) were calculated during 100.410 person years. Results OI occurred in 12.4 % of lupus, 11.5% of SV and 10.4% of o-CTD patients (p=0.72), but overall IR rates for OI were higher for lupus patients (9.87, CI 5 .49-15.76) than for SV (5.94, CI-2.81-10.24) and o-CTD patients (3.40, CI 1.62-7.23). However, whereas the IR for OI in lupus decreased over time, the IR increased for SV and o-CTD patients (Figure 1). Viral infections were the most frequent specific OI followed by tuberculosis and mycotic infections. Cryptococcal infections were observed in lupus patients only and the limited cases of pneumocystis occurred predominantly in SV patients with no cases observed after 2000 (Figure 2). In hospital mortality during OI admission was 11.5% for SV, 5.6 % for lupus and 3.5% for o-CTD patients (p=0.004). Figure 1. Figure 2. Conclusion Hospitalization rates for OI have decreased for lupus patients especially since 2005, whereas viral and mycotic OI rates have increased for both SV and o-CTD patients. Hospitalization for OI associated with significant case fatality in especially SV patients, indicating a need for increased prevention of OI. References [1]Esposito S, Bosis S, Semino M, Rigante D. Infections and systemic lupus erythematosus. Eur J Clin Microbiol Infect Dis. 2014 Sep;33(9):1467-75 Acknowledgements Supported by an unrestricted grant from The Arthritis Foundation of Western Australia Disclosure of Interests None declared
AB1481 RedOx HOMEOSTASIS AND ANTIOXIDANT RESPONSE DEFENSE IN SKELETAL MUSCLE PERFORMANCE IN THE ELDERLY
Authors: I. Ghzaiel, A. Zarrouk, S. Ben Hammouda, M. Hammami, G. Lizard, S. Hammami
Journal: Annals of the Rheumatic Diseases (2022)

<h3>Background</h3> Aging is accompanied by a progressive decline in physical activity due to a loss of skeletal muscle mass and strength considered as a geriatric characteristic defined as sarcopenia. This latter may be associated with joint damage, all of which may predispose older people to the risk of falls. Few evidences suggest that oxidative stress plays a key role in the pathophysiology of sarcopenia. <h3>Objectives</h3> The aim of this study was to clarify the relationship between sarcopenia and oxidative stress. To this end, measurements of antioxidant enzyme activities as well as levels of lipid oxidation products were performed on plasma and/or red blood cells. <h3>Methods</h3> All the participants (age ≥ 65) were classified into two groups according to the SARC-F score: non-sarcopenic patients (SARC-F &lt;4; n=50) and sarcopenic (SARC-F ≥4; n=50). Redox biomarkers: antioxidant enzymes (erythrocyte superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities) as well as, lipid peroxidation products (plasma malondialdehyde (MDA), and conjugated dienes (CD) levels), were measured using spectrophotometric methods. <h3>Results</h3> SOD levels were significantly higher in the group of sarcopenic patients than in non- sarcopenic subjects (3.20 ± 1.00 U/mg Hb vs. 2.41 ± 0.88 U/mg Hb, respectively, p= 0.007). Similarly, catalase levels were significantly higher in sarcopenic patients compared with non sarcopenicsubjects (0.13 ± 0.04 U/mg Hb vs. 0.11 ± 0.03 U/mg Hb, respectively, p= 0.008). However, no significant differences in GPx levels were detected (p= 0.254). An accumulation of lipid oxidation biomarkers MDA (17.14 ± 3.13 nmol/mg protein vs. 10.39 ± 2.60 nmol/mg protein) and CD (0.24 ± 0.09 nmol/mg protein vs. 0.17 ± 0.06 nmol/mg protein) was observed in the plasma of sarcopenic patients compared with non- sarcopenic subjects(p&lt; 0. 001 and p= 0.003, respectively). <h3>Conclusion</h3> Sarcopenia is associated with oxidative stress as shown by increased levels of antioxidant enzyme activities (SOD, GPx) and lipid peroxidation products (MDA, CD). <h3>References</h3> [1]Liguori I, et al <i>Clin Interv Aging</i>. 2018;13:757-772 [2]Ghzaiel I et al, <i>Antioxidants</i><b>2021</b>, <i>10</i>, 1772. https://doi.org/10.3390/antiox10111772 <h3>Disclosure of Interests</h3> None declared
Concerns Regarding Robotic vs Laparoscopic Right and Extended Right Hepatectomy
Authors: Duo Li, Zhi-Ying Yang
Journal: JAMA Surgery (2022)

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POS0511 PERIODONTAL STATUS BEFORE DIAGNOSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS PREDICTS CUMULATIVE DISEASE ACTIVITY IN YEARS AFTER TREATMENT INITIATION
Authors: A. Plachokova, J. Fransen, M. Koenders, R. M. Thurlings
Journal: Annals of the Rheumatic Diseases (2022)

Background Transversal cohort studies demonstrated an association between periodontal disease (PD) and rheumatoid arthritis (RA), but it is unknown how this association evolves during the course and treatment of both conditions 1 . Objectives In this study we compared RA and PD before and after RA diagnosis in patients versus controls and analyzed the relationships between disease course and treatment of both conditions. Methods Retrospective dental and RA data were analyzed of 95 RA patients from 10 years before up to 10 years after RA diagnosis. Dental data were acquired from general practices and matched healthy control patient data from the university dental college. PD was analyzed via radiographic assessment using the new periodontal classification system from 2017. The relationship was analyzed between PD and RA parameters and treatment. Results More RA patients had severe or very severe PD compared to matched healthy controls, already before RA diagnosis. The fraction of RA patients with severe/very severe PD increased from 23% before diagnosis to 43% 5-10 years after diagnosis. Patients with a more severe PD before RA diagnosis had more tooth loss at last dental follow-up and a higher cumulative DAS28 in the years after diagnosis. Two-thirds of patients with severe/very severe PD received appropriate dental care less frequently than advised by guidelines. Suboptimal dental care was associated with a higher cumulative DAS28. Conclusion PD occurs before RA diagnosis in a proportion of patients. This proportion increases in the years after diagnosis. PD is associated with a decreased response to treatment of RA. A significant number of RA patients with PD receives suboptimal dental care, which is associated with diminished response to RA treatment. References [1]Scher JU, et al. Periodontal disease and the oral microbiota in new-onset rheumatoid arthritis. Arthritis Rheum. 2012 Oct;64(10):3083-94. Figure 1. periodontitis severity in the years before RA diagnosis was scored from stage 1 to 4 (mild, moderate, severe, very severe) according the periodontal classification system from 2017. The time averaged DAS28 was calculated by taking the mean of the available DAS28 scores in the first 10 years after diagnosis and correcting this for the time intervals during which these were acquired. Linear regression analysis was performed. * = P &lt; 0.05. Acknowledgements Jill Hadisurya, Julia van Bergen, Floris Scholle, Isabelle van Dorp, Sabine Oerlemans, Araksya Zakaryan for data collection, Thea van Gaalen for data management. Disclosure of Interests None declared.